Provider Demographics
NPI:1982747606
Name:TYRRELL, ARTHUR R (RPH)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:R
Last Name:TYRRELL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10706 N KENSINGTON CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-2483
Mailing Address - Country:US
Mailing Address - Phone:509-466-8223
Mailing Address - Fax:
Practice Address - Street 1:928 S PERRY ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-3463
Practice Address - Country:US
Practice Address - Phone:509-535-1725
Practice Address - Fax:509-535-2345
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00007515183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPH00007515OtherPHARMACY LICENCE